肉毒杆菌毒素A水凝胶治疗婴幼儿型内斜视  

Study of botulinum toxin A gel for treatment of infantile esoropia

作　　者：钟华红[1] 陈静嫦[2] 麦光焕[2] 邓宏伟[1] 邓大明[2] 

机构地区：[1]深圳市眼科医院暨南大学附属深圳眼科医院 深圳眼科学重点实验室,深圳518040 [2]中山大学巾山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2016年第8期868-871,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨非肌电仪（EMG）引导下肉毒杆菌毒素A（BTXA）联合透明质酸钠（BTXA水凝胶）治疗婴幼儿型内斜视临床疗效。方法选取2013年7月至2014年11月就诊婴幼儿型内斜视患儿15例，七氟烷吸入全麻下无EMG引导双眼内直肌注射BTXA水凝胶2．5U／0．05ml／眼。注药前、注药后1d、2周、3周、3月、6月检查眼外肌功能状态、睑裂大小等，注药前、注药后3周、3月、6月测量患儿斜视度等。结果注药前、末次注射后3周、3月、6月各平均斜视度为（＋36．5±11．5）^Δ、（＋3．9±12．2）^Δ、（＋7．0±8．8）^Δ、（＋8．8±11．2）^Δ，治疗后各时间点斜视度与治疗前斜视度差异有统计学意义（P〈0．05）。末次注药后3周与3月正位率差异无统计学意义（P〉0．05）。末次注药后3月与6月相比，正位率下降，差异有统计学意义（P〈0．05）。并发性上睑下垂及垂直斜发生率明显低于传统EMG引导下BTXA水溶液注射并发症发生率。结论非EMG引导下BTXA水凝胶注射治疗婴幼儿型内斜视疗效较好，明显减少了并发症的发生。Objective To evaluate the clinical efficacy of botulinum toxin A （BTXA） gel with- out electromyographic （EMG） assistance for treatment of infantile esoropia. Methods Fifteen neurologically normal children were entered into the study once the initial diagnosis of infantile esotropia had been made from July 2013 to November 2014. The both medial rectus of these patients were injected with 2.SU/0.05ml per eye with general sevoflurane inhalational anesthesia. Extraocular muscle function and blepharophimosis size were performed at the time of prior injection, 1 day, 2 weeks, 3 weeks, 3 months, and 6 months after the injection. The effectiveness of the injection was noted in terms of squint angle at 3 weeks, 3 months, and 6 months after the injection. Results The mean squint angle of prior treatment was （＋36.5±11.5）^Δ. And the mean squint angle after 3 weeks, 3 months, 6 months of the final injection were （＋3.9±12.2）^Δ,（＋7.0±8.8）^Δ,（＋8.8±11.2）^Δrespectively. The mean squint angle at prior treatment had significant difference with that of 3 weeks, 3 months and 6 months after the final injection （P 〈0.05）. The cure rate had no significant difference between the times of 3 weeks and 3 months after the final injection （P 〉0.05）. Significant difference of the cure rate was between the times of 3 months and 6 months after the final injection （P 〈0.05）. The most common complications were ptosis and vertical deviation. The frequency of complications was significantly decreased in the means of injections of BTXA gel without EMG assistance than that had been reported by other authors （P 〈0.05）. Conclusions Injections of BTXA gel without EMG assistance is an effective and safe therapeutic approach for infantile esotropia, with the similar effectiveness and less frequency of complications compared with those of traditional means.

关 键 词：婴幼儿型内斜视 肉毒杆菌毒素A 肌电仪 透明质酸钠 

分 类 号：R777.460.5[医药卫生—眼科]